CHAPTER 4: TELLING MOM

When you can't wait any longer

But there's no end in sight

when you need to find the strength

It's your faith that makes you stronger

The only way you get there

Is one step at a time

“one step at a time” by Jordan Sparks

Arriving at Phoenix Sky Harbor International Airport the next day was one of the greatest moments of relief I had experienced in a while. I was HOME! I was with the people who will take care of me selflessly and unconditionally-my family. I caught a glimpse of my sister who was anxiously awaiting my arrival. I hurried over towards her, and when we hugged it was as if this was the first time I had breathed since learning of the terrible news. Still, I could not forget that the hardest task remained ahead-telling MOM!


On the drive home, my sister and I discussed how to approach the subject so that I can deliver the news to mom as gently as possible. Dad was working overseas and we would have to tell him over the phone (which was exactly what I wanted to avoid doing), but we will tackle the dad issue later. We decided that we would ease mom into this by telling her that the mass could be something simple and benign and possibly easily treatable. Since we really did not know what it was yet, there was no point of mentioning the frightening word “cancer” in that conversation.


However, I realized that I had underestimated mom. Sometimes in situations of extreme difficulties, certain people who may otherwise be fragile and vulnerable may surprise us. I was mom’s child, and I think she realized how much I needed her to be strong for me during this time…and she was! She accepted what I was telling her so much better than I had imagined, and we quickly started discussing what the next steps were that we had to take. Of course she was my sweet emotional mom too, so the tears still flowed, but she remained strong and rational even though I know inside she was full of fear and uncertainty. So was I, so was my sister, and so were my brothers. We were all just putting on a façade of being strong, because sometimes when life hits you with unimaginable blows that is the only way to survive! Breaking down and crumbling into a human ball may seem like the more attractive alternative in such circumstances, but it is not the way that will win the battles of life. To win a struggle, one must face it with determination, strength, hope, and sometimes even belief in what may seem like the impossible…Kind of like what Elizabeth Gilbert says in her book Eat, Pray, Love:

“…my Guru once said---that you should never give yourself a chance to fall apart because, when you do, it becomes a tendency and it happens over and over again. You must practice staying strong, instead”...

For in hope we have been saved,
but hope that is seen is not hope;
for who hopes for what he already sees?
But if we hope for what we do not see,
with perseverance we wait eagerly for it.
Romans 8:24-25

CHAPTER 3: GOODBYE FLORIDA

I think I'm moving but I go nowhere

Yeah, I know that everyone gets scared

But I've become what I can't be, oh

Stop and stare

You start to wonder why you're 'here' not 'there'

And you'd give anything to get what's fair

But fair ain't what you really need

Oh, can you see what I see?
“Stop and Stare” by One Republic

I was thinking about what to include in this chapter of my story, and I had the sense that it was going to have a mainly melancholic tone. However, I woke up this morning and listened to one of my favorite spiritual leaders, Joel Osteen, on TV. His message for today was titled “Be Glad Continually” and it was exactly what I needed to hear during this time of my life. His message can be summed up when he says, “Don’t be determined to never have problems, but be determined to always have joy in the midst of all your problems.” Basically, he calls on us to always have a smile on our faces despite what we might be going through in life; the smile that reflects that even when we feel that we have no control of our own lives, we still know that God is in control! After listening to that, I want to somehow make this chapter “upbeat”, and try to make at least a couple of my readers laugh or smile by the end of it. I hope I am successful, so here it goes-chapter 3…

As I was getting ready to leave the Florida ER, Dr. Comfort gave me prescriptions for the medicines I would need until I made it home to Arizona. That basically included a steroid to keep my facial swelling under control so I don’t unintentionally scare any innocent bystanders by having another “puff face” episode. I also got Plavix (a blood thinner) for the suspected thrombus on my neck. The intern, Dr. Blessing, walked with me as I was leaving the ER. At this point, her eyes were visibly red from all the crying she had done as we heard the CT scan news. We stood outside. She hugged me goodbye, now crying even more, and gave me her phone number to call her if I needed anything. The funny thing is that anyone seeing the two of us then would have thought that she was the one who was just diagnosed with a mass, and I was the one comforting her. Poor thing kept apologizing for breaking down like that, and telling me how strong I was for keeping it together. I wish I could have told her two things. First, I just wanted to make her understand that apologizing for something like this was not only silly, but it was a crime! She was apologizing for being compassionate, for being supportive, and for feeling sad that such a monster was growing in me. No one should have to apologize for being that humane, but I did not have the strength to tell her that at the time. All I could do then was hug her back, and say “thank you!” Second, the truth is that I am good at faking being in control of my emotions in public; it is really like a kind of art. Proof of that is that I had only shed a few tears in the ER, which I quickly put under control, but as soon as I made it to my car and I was alone, I broke down crying. It was little tears at first of “oh my God, is this really happening to me?!”, but the flood gates opened wide when I finally made it to the loneliness of my apartment!

Except there was a lot that needed to be done, and I obviously could not do any of it if my hands remained occupied with the box of tissues! So, with tears under control, first thing I did was call my brother in Atlanta; I decided it would be easier to start with him. Plus, I wanted to arrange for my flight home to have a layover in Atlanta so I could see him. I made sure my voice was as calm as I could manage before I called him. He was shocked to say the least; I only talked a few minutes with him and we hung up, I could tell it was a lot of “fresh” news for him to handle. But he called me back a few minutes later, and started doing the brotherly thing, you know, comforting me, telling me not to worry and that everything will be just fine etc. etc. He later confessed that in between the two calls he had kicked a few walls and doors on his way to class! (This explains why he was much more composed during the second call ;) Next, I called my sister in Arizona after I booked my flight, explaining everything all over again. I told her to pick me up the next day from the airport, and to not mention ANYTHING to mom. It would be much easier to explain things to mom face to face.

After that, I realized staying in my apartment alone was out of the question. So, I gathered up my laptop and purse and went to a Panera Bread that was just down the road from my apartment. If I was going to stay sane, I needed to be around people---even if the people were complete strangers. Once there, I called the only true new friend I had made down in Florida, “Zero”, and asked her to meet me at Panera after work (there is a very funny story behind the nickname I chose for her, which I will not disclose here!) I also called my good friend, HRL, and asked her if she would meet with me after her shift ended because I really needed to be with someone. HRL told me she would meet me at Panera as soon as she could leave; she called me back less than 30 minutes later and told me that her attending allowed her to leave early and that she was on her way. I felt so relieved, I really did not want to spend that evening/night alone, and now the two people I could count on in Florida were going to be there for me when I needed them the most.

That night turned out to be a very fun one, which is ironic considering the circumstances. After I explained my current life crisis, Zero and HRL did what friends do—they started comforting me and offering their help. Zero offered to drive me to the airport the next morning, which I appreciated greatly considering I had to leave at 6AM! (She had also made me a “get well” card from scratch and colored it with crayons when she had run into me in the ER earlier that morning!) Zero left after dinner, and HRL said she would spend the night with me even though she had to be at work at 5AM! And in a typical HRL fashion, that night, I laughed more than I had in a long time. We were even making jokes about the possibilities of what this mysterious mass may be. Somehow we ended up watching “Patch Adams” after I had mentioned that I’ve never seen it; HRL of course thought that it would be the perfect end to a memorable night of ice cream eating and laughter. She actually drove all the way to her apartment and back to fetch the DVD just so we could watch it that night. We fell asleep halfway through the movie. I did not have the deepest of sleeps that night, but when I woke up around 4AM and glanced towards the other couch where HRL was sleeping (we had decided to just camp out in my living room), all I could feel was peace and gratitude that I had friends who cared.

When it was finally time to get off the couch and get ready for the airport, I had this sense of excitement and relief. I had made it through the night, and I will be home with my family in a few hours; I don’t know what else I was expecting, but I suppose the previous day’s news had rattled me a little more than I thought.

Zero was at my door right on time, all awake and smiling as if it was not only 6AM! During the short drive to the airport, I realized that I did not know if I would see my friend Zero again. I did not know what the future held, but I knew I would not be coming back to Florida anytime soon. I felt a little sad. I had grown to love this friend even though we had only met a few months ago; she had definitely proven to be a true friend-the kind that a person would like to keep for life. She dropped me off by the curbside, and we hugged each other goodbye.

I boarded my flight. Soon, the plane started to move, and I found myself silently saying a little prayer. “Dear God, please just get me to my family safely and without incident…please, don’t allow the little thrombus to dislodge and damage my beautiful brain!” Following that little plea I could feel all of my fears evaporating, or at least becoming temporarily suspended for the rest of the flight…

Consider it all joy, my brethren, when you encounter various trials,
knowing that the testing of your faith produces endurance.
And let endurance have its perfect result, so that you may be perfect and complete, lacking in nothing.
James 1:2-4

CHAPTER 2: To Leave or Not to Leave?

“Never really said too much
Afraid it wouldn’t be enough
Just try to keep my spirits up
When there’s no point in grieving”
“Light On” by David Cook

It was a Friday morning on Nov. 21st, 2008 when I woke up feeling exhausted. “Of course I’m exhausted, I’m a medical student on a surgery rotation” I thought to myself, “all med students are exhausted right?” I slowly dragged my body out of bed, and looked in the big square mirror I had leaning against the wall in my room (because I had no one around to hang it on the wall for me). Why is my face looking puffier today? DAMN! My face is swollen! I examined my reflection in the mirror more closely and saw that my lips and eyelids were especially swollen to about twice their size. I sat on my bed and started crying. Now, the tears were not just because I saw my face swollen. It was a multiple of factors that caused me to cry that morning, one of which was fear, because I had no idea what to do. Should I still go to work? Should I call in my attending and take the day off? But then what? I will be trapped here in my apartment alone not knowing what was wrong with me. So I finally decided to attend the morning lecture for students/residents, and maybe ask some of the nice interns for their advice or see if they have a doctor that they recommend for me to go see.

Thankfully, after washing my face and applying some makeup my face looked more normal, but I was sure people would still notice (or at least I could easily tell it was not my normal face). I made it to the hospital and kept my head down while I walked to the elevator; I did not want to scare anyone with my abnormally puffy face! I still secretly hoped one of the interns or students would notice though, so they could help me decide on what to do. As I was waiting for the elevator, one of my favorite interns came with his breakfast in hand. He greeted me and immediately followed that with “you look tired today Nancy.” well no kidding! By the way, this is one of my favorite statements to hear from people (sarcastically speaking). It is usually a nice and polite way of saying “you look like hell today” or even, “dear God! what made you think you should come out in public today!” Anyhow, today I was glad I received that comment, because I took it as my opportunity to tell the intern what was going on and ask for his advice. (I will refer to this intern from here on out as Dr. Fine).

After all, I was scared. I felt alone, and I did not have my family and closest friends around to run to for help. No, I was on my own in Florida, after I had made the unwise choice of moving down here to do my third year rotations leaving everything familiar behind. I thought it would be an exciting adventure…Living somewhere new, meeting new people, and being so close to the beach! However, I should have listened to the saying that “home is where the heart is.” I had left my heart stranded, confused, and divided somewhere between Georgia (and the south) and Arizona, and because of that reason I never felt at home in Florida-not even for a day! In fact, I was counting down the days to when I would leave that wretched place.

After listening to me, Dr. Fine suggested that I talk to the doctor who was actually giving us the lecture that morning. He also reassured me that whether it’s an allergic reaction or something else then I will most likely just be given some steroids to bring the swelling down. My other option, Dr. Fine said, would be to go down to the hospital’s ER and just talk to the ER doctor there after lecture was over. I liked the second option better mainly because I knew all the ER doctors and staff since I had already completed that rotation months earlier.

Lecture was torture that morning (even more so than usual); I do not remember paying attention to any of it. I just wanted it to end so I could leave. One of my friends sat next to me, and asked me what was wrong; when I said “nothing I will be ok” she replied quietly “yeah right!” But she let it go, probably sensing that I did not want to talk about it then and there. Honestly, I was just feeling vulnerable that morning, and I was sure that if I tried to talk about it I was going to break down into tears, which was something I wanted to avoid at all costs. I also hate the feeling of not being in control, and that day I could tell that I was not in control of anything!

Lecture over. I take the elevator down, this time with another one of the nice interns (whom I will call Dr. Blessing because of all her help to me that morning). She too asks if I was tired or something along those lines. Man, I must have truly looked terrible that day! At any rate, this time I could not hold it in anymore, and I started crying right there in the elevator as I explained to her how I had no idea why my face was swollen, and I did not know if I really wanted to go to the ER or not. Dr. Blessing immediately said that she will come with me to the ER and talk to the doctor herself, and that I should not worry. I cannot express how much I appreciate what she did for me, but from that point on that day in the ER she pretty much took care of everything I needed. She stayed with me until I left the ER at 11:45 AM (keep in mind, that Dr. Blessing had just ended her night shift at 7AM…went to morning lecture…and was probably ready to just go home and crash in bed by the time lecture ended at 8:15AM! But she refused to leave me despite my many attempts later on at telling her that I was ok.)

Once I made it to the ER with Dr. Blessing, things moved pretty fast. We both talked to one of my favorite doctors, who thankfully had the morning shift that day (Dr. Comfort). He thought that I did not really need a neck CT scan since he suspected it was just an allergic reaction, which was what I thought as well. I had been on my surgery rotation since the beginning of November, and I had to scrub in multiple times a day, so I explained to him that maybe I was allergic to the scrubbing detergent or gloves or…?

However, that morning I had also noticed my right neck vein was visibly distended. This was the most concerning thing to me, and I did not see how it could be explained by a simple allergic reaction. So upon the insistence of Dr. Blessing and me, Dr. Comfort ordered the neck CT scan.

While we sat waiting for the CT tech to come get me, I was joking around with Dr. Blessing about how I am going to end up having a brain tumor or some kind of weird case that they can present later on at one of the morning lectures. You see, paranoia and hypochondriacism are the two most common traits among the oh-so-intelligent human breed of medical students and residents. Well, as it turns out I did not have a brain tumor but I sure did have a tumor ha! Ok universe, lesson learned…I will never ever joke about things like that anymore, or will I?!

Shortly after the CT scan was performed was when I found myself standing in Dr. Melodrama’s radiology room. He had so graciously agreed that I be present in the room while he read the scans, and he treated me more as a colleague than as a patient. I realize that it was an exception he made for me since I was a med student, and I thank him for that.

After the finding of that nasty anterior superior mediastinal mass (which basically means a tumor/mass in the area behind the breastbone and above the heart)—things started to get more ridiculous. All I wanted to do was get on the next available plane and fly home, but Dr. Comfort was concerned and did not want me to leave the hospital. Something else had showed up in my scans that Dr. Melodrama read as a thrombus in the left neck vein (thrombus = blood clot). Dr. Comfort was explaining to me the risks of flying while having a blood clot that could dislodge at any second, and go to my brain causing some serious damage (or what we call in the medical field a stroke!) Of course I knew all of that, but I did not care; I wanted to go home to my family as soon as possible. I did not want to be admitted to a hospital in Florida, and certainly not THIS hospital where I knew practically half the medical staff.

I could see it in Dr. Comfort’s eyes that he really did not want to let me go, he was worried about me almost like a father worries about his daughter. However, I was his patient, and patients have autonomy. It is this autonomy that allows patients to leave the hospital AMA (Against Medical Advice) by signing a paper indicating that they have listened to the doctor’s explanation of why it is necessary for them to stay in the hospital and what the risks of leaving are, but they still choose to leave at their own will. That was what I chose that day; I decided to leave the hospital AMA…

But when Jesus heard this, He answered him,
"Do not be afraid any longer; only believe, and she will be made well."
Luke 8:50

CHAPTER 1: HOW IT ALL BEGAN

"I'm hangin' on another day
Just to see what you throw my way
And I'm hanging on to the words you say
You said that I will be OK"
"Broken" by Lifehouse

I stood in the cold and dark radiology room staring into the computer screen showing the many slices of my body. I don't think my eyes were blinking much. My brain was trying to stay focused on every word that Dr. Melodrama was saying but that became increasingly difficult after hearing the words "anterior mediastinal mass."

Probably sensing or expecting my state of shock, Dr. Melodrama found the need to repeat his sentence multiple times while placing his hands on my shoulders and looking me in the eye, "are you hearing me young lady? What you have is a superior anterior mediastinal mass." Now with my limited medical knowledge as a third year medical student I sort of knew what that was but not exactly; the words "mass" or "tumor" are generally bad and would involve numerous tests and possibly numerous doctors to determine exactly what the mass is. All I knew at the time though was that my life was going to change and it was not a change that I was going to welcome.

My mind was flooding with questions that needed immediate answers. What is this mass? Is it treatable? How drastically is my life going to change? Am I going to have to halt everything I'm doing with my life for this mass?

Oh dear God, how am I going to tell my parents? I don't want to put them through this (again)!

You see, I am not one of those people whose life has been easy for them up to "this point"; the point when something major happens to change their entire life, like say having to face cancer. I thought my life has been plenty difficult to last me my entire earthly existence thank you very much! And silly me, I honestly thought I had already faced the biggest hurdle of my life back when I was 13 and was diagnosed and treated for severe scoliosis. Well, apparently the universe did not think so; the powers out there thought that "oh maybe little Nancy has not had enough yet, let's spice it up for her a bit more!"

I am Nancy. I'm 25 years old, and this is how my story with Hodgkin's Lymphoma starts. The decision to share my story on the World Wide Web took me over 4 months to make, but I finally decided it was something I had to do, both for myself and for others out there who may be struggling through the same battle. I also figured it will be much easier to update my friends and family on my progress in this battle, which I realize is a lifelong battle, but one I am very determined to win!

Finally, through this blog I can write, and write regularly hopefully, which has always been one of my passions. Unfortunately, it is a passion that was lost and became one of the many victims of my choice of going to medical school three years ago. It is a passion that I can now claim back (however temporarily) while I "enjoy" my one year medical leave of absence from the crazy life of a medical student!

My blog will be organized into "chapters" and even though I am just starting to publish the posts (in April 2009), I was actually diagnosed with Hodgkin's back in Nov. 26^th, 2008. I will try to mention the major dates in the chapters when they are relevant. The idea of organizing the blog into chapters comes from my dream of one day having my writings published into a book (or two or many ;)

I will also start each chapter with a line from a song and end it with a verse from the bible. The two things that are keeping me strong and motivated during this time in my life (besides the support of so many people around me) are my faith in Jesus and his unending love, and the lyrics from my favorite songs! I don't think there is anything else in the world right now that affects me as strongly as the truth found in the bible and the beauty and strength that I find in some song lyrics. So I hope you find solace and strength in those lines as much as I do!

Wait for the Lord;
Be strong and let your heart take courage;
Yes, wait for the LORD."
Psalm 27:14